Critical social determinants of childbirth outcomes in remote mountains: Voices of women from Nepal

Objectives: Despite efforts made by the Government of Nepal to reduce maternal and newborn mortality nationally, the rate is still significantly higher in remote mountain areas. This research aimed to fill a gap by asking women about socio-cultural factors influencing childbirth outcomes in remote mountain areas of Nepal. Methods: This study used a qualitative approach guided by the principles of social constructionist and feminist critical theories to derive factors influencing women’s experiences of giving birth and childbirth outcomes. In-depth interviews were conducted with 25 pregnant and postnatal women. A thematic approach was used for data analysis. Results: Childbirth outcomes in remote areas are influenced by the broader social determinants; specifically, physical access to hospital services; remoteness, poverty, and food insecurity; and disconnect between policy, practice, and reality. Conclusions: Women’s voices highlight the influence of critical determinants in determining childbirth outcomes, a situation which requires an immediate policy shift to a social determinants approach to improve maternal and newborn survival rates.